No abstract

For several reasons including thefailures of deinstitutionalization, the inadequacy of community resources, and poor coordination among service agencies, the needs of people with long-term mental illness living in the community have not been adequately met. Yet recent changes in the mental health care treatment system have sustained the shift in the locus of mental health care from inpatient settings to the community. This article discusses the characteristics and needs ofpeople with long-term mental illness living in the community. Gaps in service are identified, and an innovative assertive community treatment approach to close some of those gaps is described. Suggestions are proposed for differentiating the role of the psychiatric nurse from other clinicians in assertive community treatment teams.